Closed chest drainage without an underwater seal

Six hundred and eighty-five patients requiring pleural drainage were referred to and managed by the Cardiothoracic Unit of the University College Hospital, Ibadan between June 1985 and September 1992. Two hundred patients, in which Aldon's urobag (e.g. Simpla S4 type) was used for pleural drainage were studied. The indications for pleural drainage were pyothorax or pyopneumothorax (106 patients), malignant pleural effusion (53 patients), tuberculous effusions (23 patients) and chest trauma (18 patients). In seven of these patients, the Aldon's urobag was used for out-patient care pleural drainage. Some of the reasons for discontinuing its use were major tracheobronchial injuries (2 patients), clotted haemothorax (5 patients), chronic empyema thoracis (10 patients) and loculated malignant pleural effusions. The few easily surmountable complications encountered were obstruction of the tube by blood clot and fibrinous coagulate, stoma necrosis and periosteal reaction. The advantages observed from the use of Aldon's urobag for pleural drainage were reduction in cost of pleural drainage, availability of this drainage system and its use for out-patient care when indicated.